Healthcare Provider Details

I. General information

NPI: 1063567964
Provider Name (Legal Business Name): PAMELA V GEDNEY DNP, FNP-BC, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 02/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E POLK ST
WASHINGTON IA
52353-1237
US

IV. Provider business mailing address

PO BOX 909
WASHINGTON IA
52353-0909
US

V. Phone/Fax

Practice location:
  • Phone: 319-653-5481
  • Fax: 319-353-6406
Mailing address:
  • Phone: 319-653-5481
  • Fax: 319-353-6406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA-056296
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: